The Big and Small of it All

All pregnancy bumps are different, so it’s no wonder that some women worry their pregnant tummies might be too big, too small, or the wrong shape.

WORDS HARTINI ABDUL RAHMAN-LAI

The most prominent sign of pregnancy is a bulging belly. Even though at times it may be unwelcomed, it is hard to stop people from commenting on the size and shape of your pregnant tummy. Some say it’s too small, some insist it’s too big while others swear they can predict the gender of your baby simply by looking at your belly. The experts divulge the truth behind the shape and size of a pregnant belly.

Size of Belly

For most mothers who have undergone more than one pregnancy, they find that their tummies are bigger the second (and subsequent) time round. Dr Choo Wan Ling, an obstetrician and gynaecologist from Gleneagles Hospital Singapore, explains that this is because after the first pregnancy, the abdominal and uterine muscles are more lax. As a result, they do not ‘hold’ the baby into the tummy as well. Dr Seng Shay Way, specialist in obstetrics and gynaecology & Consultant from Raffles Fertility Centre and Raffles Women’s Centre, further clarifies that a large uterus can also be due to several factors such as polyhydramnios where the amniotic fluid is excessive, multiple pregnancies, pregnancies that are wrongly dated and masses in the uterus like fibroids or ovarian cyst.

Your genetics, body type and fitness level also affect the size of your pregnant belly. Women who have strong muscle tone tend to have a smaller belly while those who have a low body mass index (BMI) may put on more weight and have a bigger belly.

Due to the many factors influencing your weight gain during pregnancy, it is hard to pin point the exact reason why your belly is bigger or smaller than it should be. It is always best to check with your doctor should you have any concerns about the size of your belly.

Fundal Height

Some doctors measure the fundal height to check a baby’s general growth. Fundal height is the distance from the pubic bone to the top of uterus and is usually measured in centimetres. Typically, after 16 weeks of pregnancy, fundal height should correlate with the number of weeks you are pregnant. This means that if you are 22 weeks pregnant, your fundal height should be 22cm.

A fundal height that measures smaller or larger than expected — or increases more or less quickly than expected — could indicate conditions such as:

Slow foetal growth (Intrauterine Growth Restriction)

Rapid foetal growth

Too little amniotic fluid (Oligohydramnios)

Too much amniotic fluid (Polyhydramnios)

Uterine fibroids

Premature descending of baby into the pelvis or settling of baby into a breech or other unusual position

However, measuring fundal height is just an estimate and may not be entirely accurate. Your fundal height may at times be somewhat smaller or larger than expected. This might happen if:

Your body mass index (BMI) is high

Your bladder is full during the check-up

You are having multiple pregnancies (twins or triplets)

Shape of Belly

The shape of your belly usually reflects the position of your baby. The most desired position for a smooth and natural delivery is the cephalic presentation, where the baby’s head enters the pelvis first. According to Dr Choo, even in a cephalic presentation, where the baby faces also affects labour. It is easier to deliver a baby in an anterior position (baby faces your back) as opposed to one in a posterior position (baby faces your tummy). In the latter, the labour may take longer and the mother may get backaches during the labour process with higher chances of needing a Caesarean section. This is because the baby’s head is seemingly larger because the top of the head, rather than the circle of the crown, is trying to enter or has entered the pelvis first.

Carrying a baby in an anterior position will give your tummy a “basketball belly” look. On the other hand, your tummy may not look as round if your baby is in a posterior position. Instead, there may be a dip after your belly button due to the baby facing upwards.

Dr Choo stresses that whether your tummy is high or low is irrelevant as long as the baby’s head is engaged.

In some positions, there tends to be more discomfort especially when baby or mummy is moving. “The usual areas of discomfort are around the rib cage and in the pelvic area. Pain in the pelvic area is typically in the front centre area where the pelvic bones join. This is due to the separation of the bones as the baby grows. Pain is usually triggered when mummy turns in bed, squats, gets up or sits down. To minimise discomfort, a pregnant mummy can try to wear a support belt. Another option is to reduce movements that ‘open’ up the pelvis. Lying down or going on all fours may also help to relieve the pressure there,” advises Dr Choo.

Gender Prediction

Many people claim to be able to predict the gender of your baby simply by observing your pregnant bulge. Medically speaking, there is no scientific evidence to support gender prediction based on the shape and size of a pregnant belly. Even ultrasound scans are not 100 per cent accurate, although they give a pretty good guess whether you are carrying a boy or a girl. The only way to accurately know a baby’s gender is to check the unborn baby’s DNA, but that requires amniocentesis or chorionic villus sampling. Those are invasive procedures that pose a risk to both the mother and baby and are usually only carried out if there is a risk of a gender-related problem with the foetus.

However, if you are game enough to take the gender prediction test with a pinch of salt, you may want to try it yourself.

This test is based on simple observation but it is important to get a clear definition of the terms used in the test to avoid confusion.

Carrying low means that the baby is settled close to the pelvis.

Carrying high means that the baby is positioned higher – in the upper part of the uterus.

Narrow refers to the shape of the uterus when it protrudes frontally.

Wide refers to the shape of the uterus when it spreads out to the sides.

According to the belly test for baby’s gender, you can tell the sex of your baby by observing the position and shape of your belly. If you are carrying low and narrow, your baby is a boy. You are having a girl if you are carrying high and wide.

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